Wednesday, July 20, 2011

And maybe they are, but not because they're selling Krispy Kreme doughnuts, but rather because they're trying to support an important cause.

In case you're new to this story, short version was me blogging last week about folks fundraising for Leukemia and Lymphoma research by selling Krispy Kreme doughnuts. What I wondered aloud was whether or not fundraising for healthy causes by selling unhealthy products was the best way to fundraise.

My post caught the eye of Leukemia and Lymphoma Society Public Relations Director Andrea Greif who wrote me an email. Here's what she had to say,

"Your post, “Krispy Kreme for the Cure,” pokes fun at some participants of The Leukemia & Lymphoma Society’s Team In Training (TNT) for using sales of doughnuts as a fundraiser to help advance blood cancer research while they train for a marathon. However, your reference to some studies that allege a connection between obesity and leukemia must be taken seriously.

It is important to note that the recent meta-analyses referred to in your article, concluding that “excess body weight may increase the risk of developing leukemia," were neither randomized nor controlled by any other gold-standard approach.

Obesity does seem to associate with a slightly increased risk of leukemia, but this does not prove any causal link. Clearly, obesity is linked to serious health concerns, including diabetes, and studies have shown that fat stores can affect metabolism of some anti-cancer drugs which may at least partly explain the other leukemia finding you mention.

In any case, doughnuts eaten in moderation, especially by marathoners who need to carbo-load while training and running their races, are not the problem. TNT participants employ many creative methods to take on the challenge of fundraising for the cause, and surely there is no harm done in athletes enjoying the occasional doughnut. TNT participants are heroes in their own right, and are raising money to support the critical work of researchers who are heroes too."

Now if you read my post, you'll know I didn't poke fun at anyone, but I suppose that's in the ear of the beholder.

What was interesting to me about Andrea's response is her rationalizations - that doughnuts eaten in moderation by marathoners aren't so bad, and presumably therefore, neither is selling them to raise money for the Leukemia and Lymphoma Society.

So I agree that doughnuts eaten in moderation by anyone aren't so bad, but of course that's not the point.

The point is that organizations who care about health shouldn't be in the business of selling unhealthy products, especially products that may have a link to the condition championed by their organization. The rationale isn't because eating a single doughnut will kill you, the rationale is that elevating the brand and consumption of unhealthy products in the name of a few research dollars isn't a fair trade.

The Leukemia and Lymphoma Society, along with all other health charities, should establish guidelines and rules governing fundraising which in turn would prohibit the sale of junk food, because even if the link to leukemia isn't ultimately found to be causal, junk food's link to a veritable mountain of other chronic disease undoubtedly is.

[Oh, and Andrea, one last thing. While you're right to point out that the gold standard of research are randomized trials, I'm pretty sure we're never going to see a trial that randomly assigns people to gain weight to test the hypothesis that weight is causally linked to leukemia. Instead we're probably going to need to rely on the very types of meta-analyses that you casually toss aside as not being important.

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Family doc, Assistant Prof. at the University of Ottawa, Author of The Diet Fix, and founder of Ottawa's non-surgical Bariatric Medical Institute - a multi-disciplinary, ethical, evidence-based nutrition and weight management centre. Nowadays I'm more likely to stop drugs than start them. You can also find me on Twitter and Facebook.

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